Posts for: October, 2013
According to a recent study from the National Cancer Institute, a branch of the National Institutes of Health, the incidence of cancer is dropping and the survival rate is increasing. In general, the outlook for patients undergoing treatment for the disease is getting better and better. Unfortunately, it's possible that some essential lifesaving treatments, like chemotherapy and radiation, can adversely affect your oral health. If you (or a loved one) need cancer treatment, however, there are some things you should know that can help minimize the possible complications and side effects.
- Chemotherapy and radiation are effective cancer treatments, but they may cause oral health problems. These therapies work by attacking cancer cells, but they can also damage healthy cells, including those in the salivary glands and the lining of the mouth. Common symptoms may include a dry mouth or uncomfortable mouth sores. Cancer patients may also be at higher risk for dental disease, especially tooth decay.
- Prevention is the best way to minimize these problems. It's important to have a complete dental evaluation before cancer treatment begins. Side effects often result when the mouth isn't healthy prior to the start of therapy — so if there's time for necessary dental treatment beforehand, it can be beneficial in the long run.
- Taking good care of the mouth is crucial at this time. During cancer treatment, proper brushing is more important than ever. A fluoride gel or antibacterial rinse may be prescribed to help prevent tooth decay. Prescription medications are sometimes recommended to alleviate dry mouth, but drinking plenty of water, chewing xylitol-containing gum, or using a soothing rinse of salt, water and baking soda can help too.
- A team approach is essential for the best care. This includes coordination between dentists and oncologists (cancer specialists), and sharing information about prescription and non-prescription drugs, medical histories and treatment plans.
- It's vital to understand and follow medical recommendations. This means not only getting the necessary treatments and taking prescribed medications, but also learning to recognize the warning signs of potential problems. With the support of our office, your oncologist, and caring family and friends, we can make cancer treatment as comfortable as possible and help obtain the best outcome.
If you would like more information about cancer treatment and oral health, please contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Oral Health During Cancer Treatment.”
People who fly or scuba dive know firsthand how changes in atmospheric pressure can affect the body: as minor as a popping in the ears, or as life-threatening as decompression sickness. Pressure changes can also cause pain and discomfort in your teeth and sinuses — in fact, severe pain could be a sign of a bigger problem.
Barotrauma (baro – “pressure;” trauma – “injury”), also known as a “squeeze,” occurs when the unequal air pressures outside and inside the body attempt to equalize. Many of the body's organs and structures are filled with air within rigid walls; the force created by equalization presses against these walls and associated nerves, which in turn causes the pain.
The sinus cavities and the middle ear spaces are especially sensitive. Each of these has small openings that help with pressure equalization. However, they can become swollen or blocked with mucous (as when you have a head cold), which slows equalization and contributes to the pain.
It's also possible to experience tooth pain during pressure change. This is because the back teeth in the upper jaw share the same nerve pathways as the upper jaw sinuses — pain originating from the sinuses can be felt in the teeth, and vice-versa. In fact, it's because of this shared pathway that pressure changes can amplify pain from a tooth with a deeper problem, such as a crack, fracture or a defect in dental work.
Besides problems with your teeth, the severe pain could also be related to temporo-mandibular joint dysfunction (TMD), which is pain or discomfort in the small joint that connects your lower jaw to your skull. There are a number of causes for this, but a common one for scuba divers is an ill-fitted regulator mouthpiece that they are biting down on too hard while diving. A custom-fitted mouthpiece could help alleviate the problem.
If you've been experiencing tooth pain during pressure change events, you should see us for an examination before you fly or dive again. There might be more to your pain — and correcting these underlying problems could save you extreme discomfort in the future.
If you would like more information on the effects of atmospheric pressure changes on teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Pressure Changes Can Cause Tooth & Sinus Pain.”
Loose teeth are an exciting rite of passage in childhood; in adulthood, they're anything but. In fact, a permanent tooth that feels loose is a sign that you need to make an appointment with our office right away. The quicker we act, the better chance we will have of saving the tooth.
What causes loose teeth? In the absence of a traumatic dental injury, the culprit is usually periodontal (gum) disease. This is a bacterial infection of the gum and/or bone tissues that surround and support your teeth. The infection is caused by bacterial plaque that sits on your teeth in the absence of effective oral hygiene. Over time, periodontal disease will cause gum tissue and eventually bone to detach from the teeth. As more of this supporting tissue is lost, the teeth will gradually become loose and (if the disease remains untreated) eventually fall out.
Loose teeth can also be caused by a clenching or grinding habit that generates too much biting force. This force can stretch the periodontal ligaments that join the teeth to the supporting bone, making your teeth looser.
Whether the cause of your tooth looseness is biological (gum disease) or mechanical (too much force), treatments are available here at the dental office. The first step in treating gum disease is a thorough cleaning to remove plaque and harder deposits on the teeth (tartar or calculus); this includes the tooth-root surfaces beneath the gum line. You will also be instructed on effective oral hygiene techniques and products to use at home. This type of therapy will promote healing of the gums that will cause some tightening of the teeth. Additional treatments will probably be necessary to gain the maximum healing response to allow the teeth to be most stable. For example, we may also want to temporarily or permanently splint the loose tooth or teeth to other teeth so that biting forces do not loosen them further.
There are other mechanical approaches we can employ to prevent a loose tooth from receiving too much force. For example, we can reshape the tooth by removing tiny amounts of its surface enamel in order to change the way upper and lower teeth contact each other. We also may suggest a custom-made nightguard to protect your teeth if you have a nighttime grinding habit.
The most important thing to know about loose teeth is that it's crucial to intervene quickly. So if you are experiencing tooth looseness, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Loose Teeth” and “Treatment for Loose Teeth.”
One of your teeth's best defenses against tooth decay is its hard, outer layer made of a mineral-rich substance known as enamel. This great protector, however, has an enemy — acid — from the foods and drinks we consume as well as the acid byproducts from bacterial plaque. A high acidic level in the mouth could lead to the complete erosion of enamel, leaving teeth more susceptible to decay.
When the acid level in the mouth rises, calcium and other minerals in enamel become soft and begin to slough off, a process called de-mineralization. But the body can reverse this process with the help of saliva, which can neutralize acid. Saliva also contains calcium that can bind to the tooth surface and help replace what was lost during de-mineralization — a process known as re-mineralization. Saliva can normally accomplish this in thirty minutes to an hour after eating.
Unfortunately, saliva's neutralizing power can be overwhelmed when there is too much acid present. This occurs when we ingest substances like sodas or sports drinks that are high in citric acid. Many of these same beverages also have a high buffering capacity that slows the neutralizing effect of saliva. Ironically, we can also interrupt re-mineralization if we brush our teeth too quickly after eating or drinking something acidic. The enamel has been softened by the acid and when we brush before re-mineralization we can actually brush away some of the enamel.
There are some steps you can take to help this natural process for maintaining a healthy pH balance in the mouth. First, limit your intake of acidic foods and beverages. Drink water for rehydration, or at least acidic beverages enriched with calcium. If you do drink an acidic beverage use a straw to reduce acid contact with teeth, try not to swish it around in your mouth, and try to drink it during mealtime. Finally, wait 30 to 60 minutes before brushing your teeth after eating or drinking something acidic.
Tooth enamel is a key component in maintaining healthy teeth. Protecting this prime defense against decay will pay you dividends for many years to come.
If you would like more information on enamel erosion, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Erosion.”
Research has shown that periodontal (gum) disease can affect the health of your whole body. Evidence suggests a relationship between severe gum disease and cardiovascular disease (“cardio” – heart; “vascular” – blood vessel), conditions that lead to heart attacks and strokes. There is also a relationship between gum disease and pregnancy; mothers with severe gum disease have a higher incidence of pre-term delivery and low birth-weight babies. To understand gum disease, you may find the following facts helpful. How many are you aware of?
- Periodontal disease — Any disease that affects the areas around the teeth. The word comes from the Latin “peri” meaning around and Greek “odont” meaning tooth. Periodontal disease, or gum disease as it is commonly called, is really a group of diseases with the same outcome: destruction of the periodontal tissues, loss of supporting bone and ultimately the loss of your teeth.
- Dental plaque (Biofilms) — A bacterial film that forms on teeth at the gum line, and the reason we brush and floss. Its daily removal is necessary to keep your teeth and gums healthy. A biofilm is a biological film comprised of colonies of living organisms that are generally specific to a particular eco-system. Plaque is one type of biofilm.
- Gingivitis (“gingiva” – gum; “itis” – inflammation) — A response of the gum tissues to plaque biofilm that is left undisturbed (due to ineffective, or inadequate oral hygiene). It is the first stage of periodontal disease.
- Pocket formation — Just like a pocket on your clothing, pocket formation is the result of separation of the gum tissues from their normally healthy tight attachment to a tooth. Pocketing allows the introduction of bacteria, which perpetuate gum disease.
- Abscess — A collection of pus that forms within diseased periodontal tissues. It is experienced as pain, swelling, and discharge of pus from the gum tissues and is an advanced sign of periodontal disease.
Important Tip — Bleeding Gums when brushing teeth or flossing is not normal. It is a warning sign of early gum disease that you should bring to the attention of our office.
Contact us today to schedule an appointment to discuss your questions about periodontal disease. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”